Long-Term Symptoms Among Adults Tested for SARS-CoV-2 — United States, January 2020–April 2021

Wanga, Valentine; Chevinsky, Jennifer; Dimitrov, Lina V.; Gerdes, Megan E.; Whitfield, Geoffrey P.; Bonacci, Robert A.; Nji, Miriam; Hernández-Romieu, Alfonso C; Rogers-Brown, Jessica; McLeod, Tim; Rushmore, Julie; Lutfy, Caitlyn; Bushman, Dena; Koumans, Emilia H.; Saydah, Sharon; Goodman, Alyson B.; King, Sallyann M Coleman; Jackson, Brendan R; Cope, Jennifer R.

doi:10.15585/mmwr.mm7036a1

Cited by 72 publications

(67 citation statements)

References 7 publications

(9 reference statements)

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“…One case series consisting of 28 adults with persistent symptoms 8 mo following COVID-19-related hospitalization found ∼23% of symptoms improved following vaccination, ∼6% worsened, and an overwhelming majority of ∼71% were not different ( 53 ). In contrast, Wanga et al ( 54 ) reported that those with long-haul symptoms ( n = 100) at time of vaccination, ∼40% reported symptoms getting better, ∼37% got worse, and ∼23% did not change. To our knowledge, prospective trials investigating this have not been conducted and mechanistic investigations suggesting physiological evidence of this potential phenomenon are limited ( 55 ).…”

Section: Discussionmentioning

confidence: 93%

Nitric oxide-mediated cutaneous microvascular function is not altered in young adults following mild-to-moderate SARS CoV-2 infection

Dillon

Wolf

Alexander

2022

American Journal of Physiology-Heart and Circulatory Physiology

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Vascular dysfunction has been reported in adults who have recovered from COVID-19. To date, no studies have investigated the underlying mechanisms of persistent COVID-19-associated vascular dysfunction. PURPOSE: To quantify nitric oxide (NO)-mediated vasodilation in healthy adults who have recovered from SARS-CoV-2 infection. We hypothesized that COVID-19-recovered adults would have impaired NO-mediated vasodilation compared to adults who have not had COVID-19. METHODS: We performed a cross-sectional study including: 10 (5M/5W, 24 ± 4yrs) healthy control (HC) adults who were unvaccinated for COVID-19, 11 (4M/7W, 25 ± 6yrs) healthy vaccinated (HV) adults, and 12 (5M/7W, 22 ± 3yrs) post-COVID-19 (PC, 19 ± 14wks) adults. COVID-19 symptoms severity (survey) were assessed. A standardized 39°C local heating protocol was used to assess NO-dependent vasodilation via perfusion (intradermal microdialysis) of 15 mM NG-nitro-l-arginine methyl ester during the plateau of the heating response. Red blood cell flux was measured (laser-Doppler flowmetry) and cutaneous vascular conductance (CVC = flux/mmHg) was expressed as a percentage of maximum (28mM sodium nitroprusside + 43°C). RESULTS: The local heating plateau (HC: 61 ± 20%, HV: 60 ± 19%, PC: 67 ± 19%, p=0.80) and NO-dependent vasodilation (HC: 77 ± 9%, HV: 71 ± 7%, PC: 70 ± 10%, p=0.36) were not different among groups. Neither symptom severity (25 ± 12 AU) nor time since diagnosis correlated with the NO-dependent vasodilation (r=0.46, p=0.13; r=0.41, p=0.19, respectively). CONCLUSION: Healthy adults who have had mild-to-moderate COVID-19 do not have altered NO-mediated cutaneous microvascular function.

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Section: Discussionmentioning

confidence: 93%

Nitric oxide-mediated cutaneous microvascular function is not altered in young adults following mild-to-moderate SARS CoV-2 infection

Dillon

Wolf

Alexander

2022

American Journal of Physiology-Heart and Circulatory Physiology

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“…On the other hand, the prevalence of symptoms that remain 12 weeks after SARS-CoV-2 infection in patients non-hospitalized may be as small as 3.0%, based on tracking specific symptoms (tighter definition), to 11.7% based on the wider questionnaire which includes the questions about the 21-symptom list that was recently reported from 26,922 UK residents by The Office for National Statistics [15]. Numerous studies report intermediate prevalence rates between the above-mentioned ones [16,17]. The results clearly indicate that age, being female, poor general health, pre-existing health conditions, high viral load, obesity or being overweight and white ethnicity were associated with higher risk of long COVID in the majority of the studies [7,11,12,15].…”

Section: Discussionmentioning

confidence: 99%

Persistent Post-COVID-19 Syndrome in Hemodialyzed Patients—A Longitudinal Cohort Study from the North of Poland

Och

Tylicki

Polewska

et al. 2021

JCM

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Background: After recovery from COVID-19, patients frequently face so-called “Post-COVID-19 Syndrome” defined by clusters of persistent symptoms lasting for >12 weeks which may arise from any system in the body. The long-term health consequences of COVID-19 in maintenance hemodialyzed (HD) patients remain to be investigated. Methods: In this longitudinal cohort study we described the health consequences in HD patients requiring hospitalization due to COVID-19. They were interviewed three and six months (M3 and M6) after discharge with a series of standardized questionnaires. Results: Of 144 HD patients discharged from the 7th Naval Hospital in Gdansk, 79 participants were enrolled, 39 m (49.4%) and 40 f (50.6%) with a median age of 70.0 (64.0–76.5) and an HD vintage of 40 months (17.5–88). After discharge, 93.7% and 81% reported at least one persistent symptom at M3 and M6, respectively. The most common symptoms were fatigue or muscle weakness (60.76% and 47.04%) and palpitations (40.51% and 30.14%). Dyspnea with an mMRC scale grade of at least 1 was reported by 21.5% before infection, and by 43.03% and 34.25% at M3 and M6, respectively. A decrease in the quality of life was reported in all domains of the EQ-5D-5L questionnaire but mainly in the pain/discomfort and anxiety dimensions. Mean EQ-VAS scores were 69.05, 61.58 and 64.38, respectively. Conclusion: Our study showed that HD patients may still experience persistent symptoms six months after recovery from COVID-19, which can further reduce their already poor health-related quality of life. This study highlights the need for long-term follow-up on these patients for diagnostic and rehabilitation programs.

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“…Wanga et al 70 examined an internet survey of 3135 people (698 positive, 2437 negative) who had COVID testing performed through April 2020. The positive group were younger, employed, more urban and had higher income than the negative group.…”

Section: Case Reportsmentioning

confidence: 99%

Central nervous system outcomes of COVID-19

Doyle

2022

Translational Research

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The worldwide pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected an estimated 200 million people with over 4 million deaths. Although COVID-19, the disease caused by the SARS-CoV-2 virus, is primarily a respiratory disease, an increasing number of neurologic symptoms have been reported. Some of these symptoms, such as loss of smell or taste, are mild and non-life threatening, while others, such as stroke or seizure, are more critical. Many of these symptoms remain long after the acute illness has passed, a phenomenon known as “long COVID” or Post-Acute Sequelae of SARS-CoV-2 infection (PASC). Neurological symptoms can be difficult to study due to the complexity of the central and peripheral nervous system. These neurologic symptoms can be difficult to identify and quantitate. This narrative review will describe approaches for assessing neurologic manifestations of COVID-19, with examples of the data they provide, as well as some directions for future research to aid in understanding the pathophysiology of COVID-19 related neurological implications.

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Long-Term Symptoms Among Adults Tested for SARS-CoV-2 — United States, January 2020–April 2021

Cited by 72 publications

References 7 publications

Nitric oxide-mediated cutaneous microvascular function is not altered in young adults following mild-to-moderate SARS CoV-2 infection

Nitric oxide-mediated cutaneous microvascular function is not altered in young adults following mild-to-moderate SARS CoV-2 infection

Persistent Post-COVID-19 Syndrome in Hemodialyzed Patients—A Longitudinal Cohort Study from the North of Poland

Central nervous system outcomes of COVID-19

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